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Tubbs R.S.,Pediatric Neurosurgery
Clinical Anatomy

Over a century ago, The French surgeon René Le Fort described the anatomical basis for fractures of the mid-face. His nomenclature is still used today using the eponym "Le Fort fractures." Although Le Fort's name is well known in association with the fractures that he described, little is known of his life. Therefore, the present article will discuss the background of this important individual in craniofacial trauma. © 2011 Wiley-Liss, Inc. Source

Watanabe K.,Pediatric Neurosurgery
Clinical anatomy (New York, N.Y.)

Buntaro Adachi (1865-1945) was a Japanese physician, anatomist, and anthropologist and is most remembered for his study on human anatomic variation. At the end of 19th Century, one of the main focuses in anthropology was the comparison between the races. In Japan, anthropological studies of the origin of the modern Japanese race were carried out by Adachi and others. Adachi believed that differences went beyond the bones that were commonly studied in his day and, therefore, investigated soft tissues of the body. Two products of his intense study of variation of human anatomy were Das Arteriensystem der Japaner (The Arterial System of the Japanese) published in 1928 and Das Venensystem der Japaner (The Venous System of the Japanese) published in 1933 and 1940. These books received much attention and were praised by anatomists and anthropologists around the world. Even now, these books are invaluable as references for human anatomic variation. Herein, we provide an overview of the life and achievements of Buntaro Adachi and to our knowledge, this is the first such review in the English language. Copyright © 2012 Wiley Periodicals, Inc. Source

Costa P.,Section of Clinical Neurophysiology | Peretta P.,Pediatric Neurosurgery | Faccani G.,Neurosurgery
European Spine Journal

Purpose The combined recordings of epidural-(D wave) and muscle motor evoked potentials (m-MEPs) have been proposed in many studies in intramedullary spinal cord tumour (IMSCT) surgery, although not all agree. Furthermore, the usefulness of the intraoperative monitoring of motor systems using these methods in other types of spine surgery has not yet been clearly confirmed. The aim of this study is to test the impact of intraoperative D wave on the monitorability and motor outcome in spine surgery. Methods Intraoperative recording of posterior tibial nerve somatosensory potentials, lower limb m-MEPs (LLm- MEPs) and epidurally recorded D wave caudally to the surgical level was attempted in a total of 103 spine and spinal cord surgeries (23 IMSCT, 55 extramedullary spinal cord tumours and 25 myelopathies). Results There was a 97.1 %, overall monitorability where at least 1 of the 3 modalities was applicable in 100 surgical procedures. Baseline LLm-MEPs were recorded bilaterally in 85 cases and unilaterally in 11. A caudal D wave was recorded in 97 cases. Transient, or persistent intraoperative modifications occurred in 14/23 IMSCT, 5/55 extramedullary spinal cord tumours and in 2/25 myelopathies. The presence of a persistent stable caudal D wave was predictive of a good motor outcome even when the LL-MEPs were absent and/or when lost during surgery. Conclusions Not only is intraoperative D wave recording to be considered mandatory in IMSCT surgery but it should also be attempted in other types of spine/spinal cord surgeries. © Springer-Verlag Berlin Heidelberg 2012. Source

Levy M.L.,Pediatric Neurosurgery
Advances in Experimental Medicine and Biology

The biology of both normal and tumor development clearly possesses overlapping and parallel features. Oncogenes and tumor suppressors are relevant not only in tumor biology, but also in physiological developmental regulators of growth and differentiation. Conversely, genes identified as regulators of developmental biology are relevant to tumor biology. This is particularly relevant in the context of brain tumors, where recent evidence is mounting that the origin of brain tumors, specifically gliomas, may represent dysfunctional developmental neurobiology. NSCs are increasingly being investigated as the cell type that originally undergoes malignant transformation-the cell of origin-and the evidence for this is discussed. © 2010 Landes Bioscience and Springer Science+Business Media. Source

Kemp III W.J.,Indiana University | Tubbs R.S.,Pediatric Neurosurgery | Cohen-Gadol A.A.,Indiana University
World Neurosurgery

Objective: Headache and postcraniotomy pain can be disabling. In addition, generation of pain on manipulation of dural membranes during an awake craniotomy can limit the mapping procedure and create significant discomfort for the patient. There is controversy regarding the distribution of innervation of the cranial dura mater. Our aim was to review the literature regarding the innervation of the cranial dura mater and provide surgical case illustrations to highlight the relevance of such innervation to the neurosurgeon. Methods: A review of the literature regarding the nerves thought to innervate the cranial dura mater was performed. Case illustrations are provided to highlight such innervation patterns. Results: The cases provided reinforce the finding that the posterior part of the falx cerebri, tentorium cerebelli, and the dura mater along the middle cranial fossa floor are heavily innervated and most likely cause intense pain by their manipulation, which should therefore be avoided, if possible, during surgical procedures. Conclusions: Knowledge of the nerves that supply the dura mater of the skull and their pathways is important to the clinician who treats headache and to the neurosurgeon who operates in this region. © 2012 Elsevier Inc. Source

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